8880 SW EDGEWOOD STREET ADDRESS:
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspect;on: � -�' of
Footing Susp. Ceiling Sprink Rough-in Appr/Sdwl.
Foundation Plbg. Underslab Mech. R(_qh-in Fireplace
Post(Bearr Struct. Plbg. Top Out Elec. Rough-in 9 FII4A
Post/Beam Mech. San. Sewer Gas Line -Bldg
Flbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Li-re insulatio,i -Mech.
Underflr. Insul. Shear V1 ;i '
E'YP-Bd•�-�nQ� -Elect.
Date Requested:_ r}�• J�j Time: AM
PrJI
Address:___5 5 S
Builder. �y ;�' �� C Permit
THE FOLLOWING CpRPECTIONS
I , -7
" ""q
Inspector: f Date: �O, a5 z-
_APDROVED __DISAPPROVED '!"APPROVED SUBJECT TO ABOVE
_Call F-)r Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639.4175 Busines.• Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Posk/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall 3yp. Bd. ect
Date Requested: E5�, ;L— Time: AM _PM
Address: - 7
Builder:—_ -- Permit
THF i OLLOWING CORRECTIONS ARE REOUIRED:49J 1
�-
�o,r Q
�-7
Inspector: L Dater''
/X
XIPPROVED DISAPPROVED _APPROVED SUBJECT TO ABOVE
____Call For Reinsp.
V� r_
I - lil TGi� r7 rv.
INSPECZIION NOTICE \
City o. Tigard Building Depwrtaant
1.3125 99• Ball Blvd. Tigard. oregoa 97223 I J
Inspecti.on Line (Rec-O-•Phone): 639-4175 Business Phones 639-417 }`!
Inspections —
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Car Line PINALs
Post/Beem Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line &D -Koch.
/2
Date Requested: (` 7e,/� Time: _j&_11M —PM
/ y �7
q41
Address: 4J `" �'L"fs )—� Permit fs
Bu i lder sLL�G-�---
TBE FOLLOWING OORRRCTIONS ARE REQUIREDs
-ST�i�S• c-•-�2t � -
---- --�� �"�-1� �/i•,��>�ter– _—,
I
Inapector: Datos 9�
LL_
APPROVED DISAPPROVRD SUBJECT TO ADOVR
Call For Reinev.
Z§ACaI A !i0�ICB
City of Tigard Brsilding Departzwnt A
13125 BW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rev-0-Phone)-. 639-4175 Business Phone: 639-4171
Inspection:
FA-oting Plbg. Underalab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struet. Ran_ Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line / -7/7
Opp. Bd. -Hoch.
Date Requesteds �� I //7 Tice: ———AM PM
Addresss U V �J� Permit
Builder:
TRZ FOLLOWING CORRECTIONS ARE REQUIRED:
1
/,V �-
.9Po�� w
i/l.Af7d AL/-
Inspector:_._ � Date s
APPROVED DISAPPROVED p SUBJE:."f TO ABOVE
___Call For Reinap.
j�8 ECTION NOTICB
City of Tigard Puilding Departnnet
13125 sR Hall Plvd. Tigard, Oregon 97223
=nspection Line (Rec-O-Phone)s 639-4175 Business Phone: 3 -4171
Inspection:
Footing Plbg. Undorrlab Koch. Rough-in Appr/Sdwlk
Found. Plbg. T.:p Out Oa■ Line FINAL:
Pont/Beam Struct. San. Sewer Trading ) -Bldg.
Post/Beam Koch. Rain Drain Insulation -Plump.
Plbg. underfloor Water Line !J Gyp. Bd. -Koch.
Date Requefr`te�(A /}�
`: ( 'I �lD (� I T ! PH
Address:_ /V`V�� �/� Permit Ott-5i
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
WE
Inspector:_
APPROVED DISAPPROVED ^APPROVED SUBJECT TO ABOVR
_Call
For Reinsp.
rI SPECTIO14 ttoTIgA
i -'"
Cit? or Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (nec-�-Phone)s 639-4175 Buainess Phones 639-4171
Inspection:
rooting Plbg. Underslab Hoch. Rough-in Appi-/Sdwlk
onn ! Plbg. Top Out Gas Lina FINALS
Font/Beam Struct. San. Sewer Framinq -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbq. Underfloor Water Line / Gfp. ed. -Hoch.
D,!kta Requesteedt r Tima: p�� Mgt�� _PH
Address:_�� ��v U Permit f 2#ja L.7 , )_4
Builder:
THE FOLLOWING cmRECTIOrB ARE REQUIRED:
i
Inspector:_ f ---------- —_. Dar-:,
-_ APPROVED _ DISAPPROVHD �y APPROVED SUR.lECI TO ABOVE
call For Reinsp.
NOMMMMMMMMMIMPEnq
INSPECTION NOTE
City of Tigard Wilding Departaent
13125 SW Sall Jlyd. l'igrrd, Ore9cm 97223
Inspection Line (Rec-O--Phone)= 639-4175 Busineso Pho,.:s: 6 -4171
Inspection:_.
Wtin9> Plbg. Underslab Hoch. 1..,. j;:-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -plumb.
Plbg. Underfloor. Mater Line Gyp. Bd. -Hoch
Date Requesteds _Q Z � - Time: AN
Address:_ Permit
t
Builders
TNR FOLLOWING CORRECTIONS ARE REQUIRED:
3"� —►�'�'—`� ecce T ' f_ /�f / E"�,e F--
Inspector: V A �2
_ APPROVED nISAp
__ _ PROVED APPROVED SUBJECT TO gBOVR
_Call For Reinap.
PERMI
• CITY OF TIGARD PERMIT #ER. . . . : TMST94-026-
COMMUNITY -'.""ELOPMENT DEPARTMENT DAA E ISSUED: 07/12/94
13125 SW Hell Blvd.1'IQsn',-lregon 97223*8129 (503)63Q-4171
PARCEL. LIS 102DD•-00903
SITE ADDRESS. . . : 08880 SW EDGEWOOD ST
SUBDIVISION. . . . : EDGEWOOD ZONINGe R-4. 5
BLOCK. . . . . . . . . . : LOT. . . . .. . . . . . . . . :G
BUILDING
REISSUE: DWEL.1_1IVG UNITS:0 BASEMENT. . . . . . . . :0 s f
CLASS OF WORK. :ALT BEDRMS:O DATHS:O GARAGE. . . . . . . . . . :0 sf
TYPE: OF USE. . . :SF FLOOR AREA5—--_ -- -- REQUIRED SETBACKS-----------
TYPE
TYPE OF CONST. :5N FIRST. . . . :200 sf LEFT. . :0 ft RIGHT. :0 ft:
OCCUPANCY GRP. :R3 SECOND. . . :0 sf F'RONT. :O ft REAR. . :0 t i;
STORIES. . . . . . . :0 THIRD. . . . :0 sf REUUIRED----
HEIGHT. . . . . . . . .
ED---_HE.IGHT. . . . . . . . . 0 ft TOTAL.------:200 s f SMOKE DETECTORS. :
FLOOR LOAD, . . . :40 psf VALUE. . . . . f : 14000 PARKING SPACES. . :O
R marks : ENC .')SING LOWER DECK ON SOUTH SIDE OF HOUSE APPROX. 200 Sly. FT
PLUMBING
SINKS. . . . . . . . . . :0 FLOOR DRAINS. . . . -0 BAC'�FLOW PREVNTRS. . :0
LAVATORIES. . . . . :0 WATER HEATERS. . . :0 TRAP3. . . . . . . . . . . . . . :0
TUP/S:HOWERS. . . . :0 LAUNDRY TRAYS. . . :L71 CATCH BASING. . . . . . . .0
WATER CL_OSETC�. . :0 S=EWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . :0
D I SHH ASHERS. . . . :0 WATER LINE (ft ) . :0 OTHER I-I X'TURES. . . . . :0
GARBAGE RAIN DRAIN (ft ) . :O
WASHING MA:H. . . :0 SF RAIN DRAINS. . :0
MECHANICAL _.._......._..._.___.____.__....__.________..__. _..___-- FEES
FUEL "TYPES------------ UP'IT HTRS. . :0 type amount by date reap.
VENTS . . _ :0 BF'RT $ 110. 50 .TG 07/12/94 --
MAX INPUT :0 BTU VENT FANS. . :O BF'1_C $ 71. 83 JF 07/ 11/94 94-254331
FURN ( 100K . . :0 HOODS. . . . . . :0 B50C f 5. 53 JG 07/12/94 —
FURN ) =100K . . :0 WOOLSTOVES. :0
FLOOR TURN. . . . :0 CLO DRYERS. : 0
BOIL/CMP ( 3HP:0 OTHER UNITS:O
GAS OUTLETS:O
Owners -- - —_______._____.________—______-•-___--
MICHAEL. MCELEVEY
x3880 SW EDGEWOOD 5T
TIGARD OR 9722T
Phone #:
Contractor: - ------ ___._._____----------_----
CONTRACTOR NOT ON FILE
Phone #:
'a 1.87. 86 TOTAL
This permit is issued subiect to the regulations contained in the ---- -- - REQUIRED INSPECTIONS ------
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/foUnd Insp Building Final
applicable laws. All Mork will be done in accordance with approved Post,-'Beam Struct Erosion Control
plans. This permit will expire if work is not startfd within 186 Post/Beam Mechan Crawl train
days of issuance, or if work is suspended for more than 186 days. Mechanical Insp
� Framng Insp
Fermi.ttee G a.t;�_lre : �' IramiIn Insp
/ \\ --- _ __._ _-- Gyp p Board Insp
I s s r.l P(j N y L_ _ s.1 --.--.--------. Mechanical F inal
Cal 1 for' IT)-,pef t 1 0n - 639-4175
CITY OF T.:CARD RECEIPT OF- PAYMENT RECEIPT NO. s94--iR'.1-541+14
CHECK AMOUNT v 116. 48
NAMF_ MCELEVEY, CATHY CASH AMOUNT a 0. 00
ADDRESS t PAYMENT DATE a 07/ 12/94
SUBDIVISION
PURPOSE OF PAYMEP AMOUNT PAID PURPOSE OF PAYMENT AMOUN-r PAID
BUILDING PLRM MST94-0265 110. 50 ST. BUILD PER 5. 5.3
PLAN CHECK FF 0. 45
61180 !.iW EDBEWOOD
'10TAL AMOUNT PAID 116. 48
Wo
I`�,
Residential Building Permit Application (`
City of 'Tigard -
1312,5 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address:
Subdivision: �GY�Eu?ObC7 Lot # Office Use O 1
uation• (2a i 20b9t,,3) LEILI,-
Permit #
Owner: fr _ f!T/1`l Alf* IJC
o� / Reissue of
Address:
Map & TL # - 3
rc
Phone: _— a' -j%– R3?.7 Ap�rovats R utresl
Contractor:
t''lanru�i9
���`_ .�
Engineering
Address:
----.--------- Other
Phone: Items Requlred
Contractor's License # /�,�� Subcontractors
(attach dopy of current Oregoi license) Truss Details
Contact name 8 phone: - --- �_------
t)iher
Subcontractors:
Plumbing: /U�/�►
Mechanical:
(attach COPY current OR Contrackr's Limnse)
/ ArchttecttEngineer. k. -ha I'I'"r 5� YL, ` �t �� ''
Address: je, SoW � �~
1
Phone:
JOB DESCRIPTION: Re"low TUr dec- ox
z + ^,2w �1
. J
r �
nt signal $ ne number
Received by: Date Received:
Pen;lit # Ar^,oust Description Amour.i Amt. Pd. Bal, Due
3kiy. Farmil (BUILD)
Pwmb. Permit (PLUMB) _
Mech. Permit (MECH) ,
State Tax (TAX) s
3ldg: —SS 3
Plui.lb:
Mech:
Plan Check (PLANCK) -71
Bldg: -7113
/
Flumb:
Mech:
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP) _.
Parks Dev Charge (PKSDC)
Storm Drvinage Chg (SDSDC) !_
Residerniai i IF (TIF-R)
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C) —
Industrial TIF (TIF-I)
Institutional TIF (TIF-IS)
Office TIF (TIF-0)
Water Quality (WOUAL) �.�..
Water Quantity (WOUANT) _
Fire District (FIRE) ._—
Erosbn Crrtrl Pemrt (ERPRMT)
Erosion Plancl0l" (ERPLAN)
Erosion Planck/COT (EROSN)
TOTALS:
CITY UP lIGARD RECEIP4 OF PAti'MENr RL-.Gf-.'l P I NO. v94—e.:*p433J
CHECK AMOUNT a 71. 38
NAME t MCEL.ECEY CASH AMOUNT a 16. 00
ADDRESS a 86BLA SW E.DaEWOOD ST PAYMENT DATE. s 07/11/94
TIGARD, ORE13ON SUBDIVISION
9 7 c?2 3—
PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENI AM1.11 IN I PAI L)
PLAN CHECK F"E TI. 3s
8880 SW EDGEWOOD
EDGEWOOD LO'Tf,/Jql
TOTAL AMOUNT 1='h11I) 71. :38
INBPECTION NOTICE
Cit? Of Tigard Building Department
1-'125 SII [hall Blvd. Tigard, Oregon 97223
Inspection Line (Ree-O-Pho/n�a)e 639-4175 Business Phones 639-4171
Inspections_ hamc. Al � ,/�
Footing Plbg. Underslab Hoch. Rough-in Appr/sdwlk
FOUk.A• Plbq. Top Out Gas Lina E131dg
m
Post/BeaStruct. San. Sewer framing
Post/Beam Nech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Mater. Line Q Gyp. ed.
Date Requested' ,__.L ( 7,,,/ 1 TLees �—AN PN
►
Addreass�Q (r(JC.� �7_ Permits����/
Buildera—M
el
TNR FOLLOHING ODRRECTIONS ARB RBQUIREDs I)Y h l �9 6.) - V3tJ
Torn
C,0
- /;V(� „Oar► —
Inspectors Dates
4PPROVED DISAPPROVRD APPROVRD SU Cf TO
—_ Call For Reinap.
--
INSPECTION NOTICE
City of Tigard Building Department
13125 811 Ball Blvd. Tigard, Oregon 9722Q�
Inspection Line (Rec-O-Phone)e 639-4.175 Business Phones 639-4171
Inspections
Footing Plbg. nderslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
Post/Beam Strur_t. San. Sewer Framing �, -Bldg.
Poet/Beam Mach. Rain Drain Ineulat.ton ~ -Plumb.
Plbg. Underfloor Nater Line Gyp. Ed. -Mach. l
Date Requeateds 4.)-�/- 7Timeess 'Z-1—M
^ PM
Addreass k-4- U f 71Z���lar5mit -
Builders 1
THE FOLLOWING CORRECTIONS ARE REQUIREDs '
_ I
Inspector % Dates
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinnp.
INSPECTION MICE
CttT of Tigard Building Deparbonat
13125 BR Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Bueiners Phone: 639-4171
Inspections
Footing Plbg. Underalab Mech. Rough-in Appr/Sewlk
Found. jPlbg. Top Out Gas Line PINALs
Post,/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain insulation -Plumh.
Plbg Underfloidl,, Water Line Gyp. Bd. y rC�Mech.
Date Requested:_ _Time AM PM
ki 51 �
Address: G� ��(� i 1���1i,�G'/_� —_ Permit Is 7fBuilder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
t
Inspector _ Date: —
APPROVED DISK`^ROVED APPROVED SUBJECT TO ABOVE
Cell For Roi.nnp.
CITY OF TIGARD
OREGON
April 6, 1992
7
� Michael McBlevey
8880 SW Bdgewood
Tigard, OR 97223
Res 8880 SW Sdgewood Permit #MST 91-0145
Dear Sir:
The last inspection conducted on the above project was a gypsum
board inspection on July 31, 1991. The next required inspection
will be a final inspection.
Please advise the Building Division of the status of this project
as soon as possible so the file may be kept current.
Please note that any permit without activity for over 180 days
becomes void. if you need additional time to complete the project,
please contact this department so that an extension can be
discussed.
Sincerely,
Brad Roast
Building Official t � ,
10
Notice.A "`
13125 SW Moo BMd..P.O.Boot 23397,Tigard Oregon 97223 (503)639-4171
INSPECTION NOTICE
City of Tigard Building DepartmenIL
P.O. Box 23397
Tigard, Oregon 97223 t
Phone: 639-4175
Type of Inspection
Date Requested/�C� 1'—�� Time_—Z A.M. P.M.
Address Permit #
Ownq( _— Lot # _
Builder �/C
The following Building Code deficiencies are rjquired to be corrected:
I
i
i
Presented to A ��pproved —
Inspector —_ ] Disapproved
Date �
—�—
CALL FOR REINSPWTION
f ) YES f .I NO
INSPECTIO(i -COTIC&
City of Tigard Building Departasant
13125 BA Ball Blvd. Tigard, Oregon 97223
WA
Inapection Line (Mc-o-Phone)s 639-4175 Business Phones 639-4171
Inspections
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
Post/Beam Struct. Ban. Sower Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Yater Line Gyp. Bd. -Mach.
Data RequartedsTimee AM "QPM
Rddreses—�� [J ,�f� -P%vitI L' --
Builders C -C
TM FOLLOMIM ODRRECTIONS AREUIRED:
cz
InetAPPR
Date:
OVED v DISAPPROVED _ — APPROVED SURJSCf TO ABOVE
__.Call For Ralnnp.
C'TYOFTIFARD MASTER PERMIT
COMMUNITY DEVELOPMENT DEPARTMEPIT at
CnYOF PERMIT #. . . . . . . . MST91-0145
(rim
13126 SW Hdl Blvd P.O.BM 23397,719W,Orepn W/ (603)64 *417b C7
1 7 —
_L ' - r)ATP T_qc;1jrn-_ i-A7/,-,A/c41
'31TE ADDRESS. . . : 8880 SW EDGEWOOD ST PARCEL: 2SI02DD-00903
5LIBDIVISION. . . . : EDGrWOOD ZONING: R-4. 5
JALOCK. . . . .. . . . . . : LOT. . . . . . . . . . . . :6
------------------------------------ BUILDING
REISSUE: DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 s
CLASS OF WORK. :ALT DEDRMS:O BATHS:0 GARAGE. . . . . . . . . . .0 of
TYPE OF US(=. . . :SF FLOOR AREAS------- REQUIRED SETBACKS-----------
TYPE OF CONST. :5N FIRST. . . . :0 sf LEFT. . :O ft RIGHT. :0 ft
OCCUPANCY GRP. :R3 SECOND. . . :0 Sf FRONT. :0 ft P'_HR. . :0 ft
STORIES. . . . . . . :0 THIRD. . . . :0 sf REQU I RED--------
HEIGHT. . . . . . . . : 0 ft 0 sf SMOKE DETECTORS. :
FLOOR LOAD. . . . -40 psfVALUE. . . . . $- 5000 PARKING SPACES. . sO
Remarks-. changing bath room around moving some inter walls installing 3 window
PLUMBING
STNKS. . . . . . . . . . ..0 FLOOR DRAINS, . . . :0 BACKFLOW PREVNTRS. . iO
LOVATORIES. . . . . :2 WATER HEATERS. . . :0 TRAPS. . . . ., . . . . . . . . . :0
J U B/SHOWE R S. . . . :2 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . :0
WATER CLOSETS. . : 1 SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . :0 WATER LINE (ft ) . :O OTHER FIXTURES. . . . . :0
GARBAGE DISP. . . .0 RAIN DRAIN (ft ) . :O
WASHING MACH. . . : 1 SF RAIN DRAINS. . -O
MECHANICAL ......------- ---------------- FEES
FUEL UNIT HTRS. . -0 type amount by date r9cpt
VENTS . . . . . .0 BF-,RT $ 50. 50 JLH 07/26/91
MAX INPUT%O BTU VENT FANS. . 42 BPLC $ 32. 63 JLH 07/26/131
FURN < 100K . . :0 HOODq. . . . . . ..Q( B5PC $ 2. 53 JLH 07/2'6/91
FURN ) =100K . . -0 WOODSTOVES. :0 MPRT $ 20. 50 JLH 07/(-6/91
P'LIJOR FURN. . . . :0 CLO DRYERS. : I MPLC $ 5. 13 JLH 07/26/91
BOIL/CMP ( 3HP:O oTHER UNITS:@ M3PC $ 1. 03 JLH 07/26/91
GAS OUTLETSsO PPRT $ 45. 00 JLH 07/26/91
Owner-. P5PC $ 2. 25 JLH 07/26/91
MICHAEL MCELEVEY
8880 SW EDGEWOOD ST
TIGARD OR
Phone #:
Contractor:
OWNER
Phone
159. 77 TOTAL
I This permit is issued subject to the regulations contained in the ——————— REQUIRED INSPECTIONS ------
--
Tigard Municipal rode, State of Ore. Specialty Cedes and all other PLM/Underfloor Building Final
applicable laws. All work will be done in accordance with approved Mechanical Insp Erosion Control
Plans. This permit will expire if work is not started within 180 Plumb Top Out
days of issuance, or if work is suspended for were than 180 days. Framing Insp
Insulation Insp
i ,r,I m i Gyp Board Insp
Mechanic-Al Final
Plumb Final.
�/ Call for inspection - 639-4175
CITY OF TIGA 4D PECEIPT OF PAYME141' RECEIPT NO. a91—P-1760
CHECK AMOUNT a 159. 77
��AME s MCEt,.EVF:ilyl MICHAEL CASH AMOUNT —0- 00
i
'ADDRESS % SbaO SW' EDGrz*W(3(]D ST PAYMENT DATE 07/26191 �
SUBDIVISION
TIGARD, , OR 97223—
PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENI' qAtODUNT PA I D
PTj f RM 50. 50 FLUM31NO PERM 45. 00
'MECHANICAL PE 20.0151a ST. BUILD PER 131
'PLAN CHECK FE 37. 96
I'Ol'Al- AMOUNT PAID 159. 77
won*
CITY OF TIGAFID - RECEIPT OF PAYMENT RECEIPT NO. 191-213760
' CHECK AMOUNT i 15tl. 77
fNAME i MCELCVMICHAEL CASH AMOUNT i k?• ��
ADDRESS a 88130 3W' EDGEWOOD ST PPYMENT DATE a 07/,:16/91 �
SUBDIVISION i
T I OARD, R OR 97223—
PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF r*AYMENT � IfWUNT PAID
EU I t_D I Na�(' RM—� ~~� 5i. 50 PLUMB I NO PE RM'l ~ Y y-45. ®0
'MECHANICAL PE 20. 50 ST. BUILD PER 5. 81
'F-',LAN CHECK FE 37. 96
TOTAL AMC NT PO I D _ _> 159. 77 .-...w.
� "d!
CGL / _ 71421
CITY OF TIGARD ulusw 23397iall a PERMIT ECT # _
['OFio:27397 PERMIT #
COININIUNM DEVELOPMENT DEPARTMENT Tigud.Omgon97V3
(503)639-,171 DATE ISSUED
JOB ADDRESS: _ ��0 ��� E�gPux�d J� TAX MAP/LOT A5 VP a� 9�3
SUB: LOT:4- 2,SlZDb00g0', _ LAND USE: y
VALUATION:
OWNER ,r1 ,, -PLCIAL NOTES
NAME: /V�/ P Me,ELREISSUE OF:
ADDRESS: A20 L2Y.U2Qe LAST REISSUE:
Or2_ gnz-3 FLOOD PLAIN/
PHONE: ✓e 20 pm SENSITIVE LAND: _
CONTRACTOR APPROVALS REQUIRED
NAME: _ PLANNING:
ADDRESS: i_ ENGINEERING.
FIRE DEPT: _
PHONE: OTHER:
CONTR. BOARD #: EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: LIST/SUBCONTRACTORS:
MECH: � ' _�_ BUS 'TAX:
ABLH CNGINEER CALCULATIONS:
NAME: -�l� __ TRUSS DETAILS:
ADDRESS: OTHER:
PHONE:
PROPOSED BLDG. USE: _ — -
COMMENTS:
APPLICANT SIGNAT
Received By: Date Received:
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. -DUE
0 10-432 00 Building Permit Fees J� -
10-431 OC Plumbing Permit Fees
10-431 01 Mechanical Permit Fees ,>•u
10-230 01 State Building Tax (5%)
Building ? j
Plumbing ✓'
Mechanical 3
10-433 00 Plans Check Fee J 7't6 . 3 ?•�G
Building4',i,
Plumbing
Mechanical '
10-230 06 Fire —
30-202 00 Sewer Connection
30-444 00 Sewer Inspection _
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Fees _
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees _ —
25-448-01 Residential Traffic Fees _
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (PDC)
31-430 00 Storm Drainage Syst Dev Chrg
(SSDC)
24-445-0I Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL
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